Prognosis and survival for stomach cancer

If you have stomach cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic factors for stomach cancer.

Stage

Stage is the most important prognostic factor for stomach cancer. When stomach cancer is found in an earlier stage, there is a more favourable outcome.

The 2 most important stage indicators are the tumour and the lymph nodes. Tumours that have not grown beyond the stomach wall have a better prognosis than tumours that have grown through the wall. The number of lymph nodes that the cancer has spread to affects the prognosis. If the cancer has spread to 3 or more lymph nodes, the prognosis is less favourable than if it hasn’t spread to the lymph nodes or has only spread to 1 or 2 lymph nodes. If the cancer has spread to 7 or more lymph nodes, the prognosis is even less favourable.

Cancer cells in peritoneal washings

If cancer cells are found in the washings of the peritoneum taken during surgery, the prognosis is less favourable.

Lymphovascular invasion

Cancer that has not spread into the blood or lymph vessels (lymphovascular invasion) tends to have a better prognosis than cancer that has spread to the blood vessels.

Type of tumour

Intestinal type tumours have a better prognosis than diffuse type tumours. Adenocarcinoma tends to have a better prognosis than adenosquamous carcinoma.

Location of the tumour

Tumours found in the lower part of the stomach have a more favourable prognosis than tumours found in the upper part of the stomach.

Surgical removal

If the stomach cancer can be completely removed (resected) during surgery, the prognosis is more favourable than if it cannot be completely removed.

HER2 status

People who have tumours that test positive for HER2 have a poorer prognosis.

Performance status

People with a high performance status (Karnofsky score of 70 or greater) have a more favourable prognosis than those with a lower status.

peritoneum

The membrane that lines the walls of the abdomen and pelvis (parietal peritoneum), and covers and supports most of the abdominal organs (visceral peritoneum).

performance status

The measure of how well a person is able to perform ordinary tasks and carry out daily activities.

Examples of scales used to evaluate performance status include the Eastern Cooperative Oncology Group (ECOG), World Health Organization (WHO) and the Karnofsky performance status scale.